Sphenopalatine Artery (SPA) Ligation

Lubbe, Darlene

Sphenopalatine Artery (SPA) Ligation

Open Education Resource

2025-03-23

Abstract

SPA ligation is generally indicated for intractable posterior epistaxis that does not settle following 24hrs of adequate anterior and posterior nasal packing, and for recurrent unilateral epistaxis unrelated to an underlying systemic disease or a drug related blood dyscrasia. The sphenopalatine artery (SPA) is one of the terminal branches of the internal maxillary artery (IMA) which originates from the external carotid artery system. It provides 90% of the blood supply to the nasal cavity i.e. the lateral nasal wall, the turbinates and most of the nasal septum. The anterior and superior nasal septum is supplied by the an-terior and posterior ethmoidal arteries which originate from the ophthalmic artery (internal carotid artery system). The sphenopalatine artery is one of six terminal branches of the 3rd or pterygomaxillary portion of the internal maxillary artery (Figure 1). These 6 branches all originate in the pterygopalatine fossa which is located behind the medial part of the posterior wall of the maxillary sinus (Figures 2, 3 & 4).